Belly Tales

It’s snowing here, but here’s a little piece of news that will warm the cockles of your heart.  As we all know, there was a big stink over at Facebook awhile ago when they banned the pictures of nursing mothers, which then led to the formation of the facebook group Hey Facebook, Breastfeeding is Not Obscene, which served as an official petition and currently has 50,000+ members.  However, not content with merely joining a facebook group, breastfeeding mother Heather Farley actually organized a breastfeeding protest outside the Palo Alto headquarters of Facebook on December 28th while visiting her family in the Bay Area.  Good for her!  The world needs more nurse-ins, and this is a perfect example of an online protest moving out of the world of blogs and into the real world.

While Facebook maintains that breastfeeding photos are okay, it does have a no-nipple no-areola policy, and will remove photos that other users indicate as obscene, which is apparently what happened with the breastfeeding photos that were originally removed.  I still don’t understand how photos of teenagers clad in lingerie are acceptable while photos of breastfeeding babies are not.  While some people argue that this is for the protection of the women and babies from predators, I really think what it does is send the message that public breastfeeding is not acceptable.  It seems like any use of the breast for anything other than sexual gratification is what’s considered obscene.  In our sex-drenched culture, sexy women in lingerie won’t even make us bat an eyelash, but a baby taking sustenance from a breast….that’s obscene.  How can breastfeeding not be considered “family-friendly”?  It’s the very essence of family friendly — it’s feeding and nourishing said family.  And for the folks who wonder why people would want to even take a photo of a nursing baby in the first place…just look at all the photos taken of babies with bottles in their mouths.  It’s cute, and as a parent, I can only imagine that there’s something very satisfying and fulfilling about watching your baby eat.  Babies are born to breastfeed, and it’s not obscene.  Anyway, kudos to the lactivists of California for making their real world presence felt outside the Facebook headquarters this holiday season.

And with that, I’m off for the rest of the year.  See you next year!

Let’s face it: the economy sucks right now.  We haven’t yet hit rock bottom, and it’s going to be awhile (probably a long while) before things begin to recover.  In the midst of this harsh financial reality, companies and industries are scrambling to find ways to save money.  Birth activists have been trying for decades to convince this country of the benefits of midwifery based on its safety and track record of better outcomes, not to mention improved client satisfaction, but hey, this is America—the only thing people really pay attention to in this country is the bottom line.  So maybe midwifery has finally found the argument it needs to affect actual change.  In the midst of one of the worst recessions since the Great Depression, NOW is the time to increase access to midwifery care because it’s excellent care for a heck of a lot less than what we’re currently spending on maternity care.

In early December, shortly after the nomination of Tom Daschle as Secretary of Health and Human Services (HHS), the Big Push for Midwives launched a campaign to get Mr. Daschle to attend a community meeting on midwifery and its advantages.  Per the change.gov initiative, discussions on healthcare reform will be occurring around the country between 12/15 - 12/31, and Senator Daschle has promised to attend a few of them in person.  Thanks to the Big Push for Midwives, he was invited to several heartland discussions, including this one in Lees Summit, MO.  I haven’t been able to find any updates or reports from this meeting yet.  I’m not sure if Senator Daschle was able to attend, but it’s definitley the sort of discussion he (and the Obama administration) should be listening to. (Was anyone actually able to attend that meeting?  If so, give us an update, please!!  I’ve been searching the internet for reports on the meeting, but I haven’t found any yet.)

As this excellent recent article in the LA Times (Midwives Deliver by Jennifer Block) points out, midwives deliver much safer care for much lower cost:

The most cost-effective, health-promoting maternity care for normal, healthy women is midwife led and out of hospital. Hospitals charge from $7,000 to $16,000, depending on the type and complexity of the birth. The average birth-center fee is only $1,600 because high-tech medical intervention is rarely applied and stays are shorter. This model of care is not just cheaper; decades of medical research show that it’s better. Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast feed. In other words, less is actually more.The Obama administration could save the country billions by overhauling the American way of birth.

It seems like instead of encouraging midwifery care, the opposite is happening.  Birth Centers around the country are closing at a rapid pace, and Medicaid has recently started to resfuse to fund birth center care:

Over the past few years, CMS (the federal agency that runs Medicaid/Medicare) has begun disallowing federal matching funds for state Medicaid payments for freestanding birth centers services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987. Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.

As this article points out, this is going to cause a huge squeeze on birth centers around the country, and we’ll soon be seeing even more of them close unless something is done.  This is an urgent call to action.  The AACB has several resources on their website listing ways to contact your senators and let them know about this issue, including using this lovely flyer which lists all of the important talking points you’ll need when composing your e-mail or making your phone call (calls are preferrable, apparently, since e-mail is more likely to be lost in the midst of all the e-mails on the federal bail-out).  The reason this is so important is that Medicaid generally sets the standard for insurers.  If Medicaid stops insuring birth center care, other insurance companies will follow suit.  Birth centers are a crucial link in many communities, providing quality health care to diverse populations (including women on Medicaid - you only have to look at the work of Ruth Lubic and the Morris Heights birth center to appreciate that), and we need to keep as many of them open as possible.  Not only does it make great health sense, but it saves money too.

And here’s another great cost-saving suggestion: stop insuring preterm elective cesareans.  When I read this article I just about choked.  I can’t believe insurance companies are willing to pay for this when research has consistently shown that there are still a lot of complications with “near-term” infants (babies born between 34 - 36 wks) such as respiratory distress, jaundice, temperature instability (hypothermia), delayed brain development and feeding difficulties.  Forget the fact that a cesarean delivery is several thousands of dollars more expensive than a vaginal delivery; the real damage in this practice is caused by the increased number of preterm babies and the burden of care they demand.  Prematurity and NICU care accounts for one of the largest chunks of healthcare expenditure.  Even the March of Dimes is calling for a decrease in preterm cesareans.

I’ve always been consistently amazed that HMOs, managed care systems and Medicaid haven’t latched onto midwifery with more enthusiasm.  I wonder sometimes if this is because ACOG and the AMA are able to counteract the economic practicality of midwifery care with a tons of lobby money.  The economic angle isn’t anything new.  The Business of Being Born said the same thing in 2007, and Michel Odent, Ina May, Naomi Wolf, Suzanne Arms, Robbie Davis-Floyd etc. etc. have been saying the same thing for decades.  Maybe in the midst of the recession, the message will finally get through: midwifery care is better AND cheaper.

This is a site I found through Women’s Health News, but I felt it really deserved a post all its own.  A midwifery student decided to take a picture of her cervix every day for one entire menstrual cycle, and the pictures are absolutely amazing.  I want to print them out and show them to all of my clients who are trying to conceive as a way of illustrating what fertile cervical mucus looks like, and when they should be having sex!  She has entitled the website My Beautiful Cervix, and I can’t think of a more appropriate name.  I really need to get a mirror in my exam room and start to show women their cervix during our exams.  Women really need to see their cervix to understand.  There’s something so powerful and so positive and affirming about seeing this amazing, hidden, little secret thing inside of you that you never get a chance to see, and yet is always humming along, doing her thing.  It’s truly eye-opening.  I will never, ever forget the very first time I saw my own cervix.  In fact, I am somewhat tempted to take pictures of my own cervix for a month, and join her project.  Anyway, massive kudos to her courage and ingenuity in getting these pictures online.  Hopefully she won’t be forced to move the website again, due to heavy traffic and complaints about “inappropriate images”.  It’s only a cervix, after all.  Just think of how much more peaceful our world would be if the defining symbol underlying our culture was a cervix instead of a phallus.

It seems like every other blog/magazine/newspaper is putting together gift guides these days, so I thought I’d jump on the bandwagon too and put together a gift guide for the hard-to-shop-for midwives/ doulas/ lovers-of-birth in your life.  Granted, this guide sort of reads as a list of some of my favorite things, ever, but hey….why not?  And you never know, the beloved boy might be reading this, too.

1. Subscriptions

One of the most important (and hardest) parts of being a midwife is staying current with the latest research and information that’s coming down the pipeline.  While medical journals themselves are very expensive, they’re often a treasure trove of information that’s well worth reading.  If you’re a CNM/ CM, membership in the ACNM automatically brings the Journal of Midwifery and Women’s Health to your doorstep every quarter.  However, if you’re midwife is not a member of the ACNM, getting her a subscription to this journal could be a lovely gift.  If you really want to splurge (and/or if your midwife is an avid reader of medical research), then go straight to Midirs Midwifery Digest, which is England’s premiere midwifery publication, and really is a treat.  They will ship internationally, of course, although it’s a bit pricey.  I had a subscription for a year, and I loved it!  It’s such a breath of fresh air to read actual midwifery research, as opposed to OB research which happens to be applicable to midwives.  And of course there’s Midwifery Today, which is like candy to any birth-enthusiast.  The birth stories are truly inspirational, and Midwifery Today, much more so than the more academic journals, really captures the heart and soul of being a midwife.

If you’re looking for something more along the lines of a subscription for your favorite feminist, then I’d highly recommend Bust magazine.

2. Vulva Puppets

When I first discovered these AMAZING VULVA PUPPETS back in 2006 I very nearly wet myself with excitement.  Since that time, my vulva-puppet lust has been put on a back-burner (due in part to the hefty pricetag, which might make this gift somewhat impractical in a recession year), but I still think that this is cadillac of midwifery gifts, gauranteed to absolutely floor your midwife and send her (or him) into paroxysms of joy.  Just look at how beautiful they are—such a special, fitting tribute to the power and wonder and mystery of the vulva.  The Vulva Puppet Gallery has changed slightly; some of my personal favorite vulva puppets are now under the Limited Editions Gallery (which only works if you click on the color links, rather than the Goddess/Continent links).  These puppets will make an amazing gift for your midwife, particularly at a special juncture in her/his life, such as graduation, a new job, opening a private practice, retirement etc. etc.

3. Birth Secret, by Brian Andreas

I found this print in a gallery in Woodstock, NY, two days before our wedding, and I bought it on the spot.  It’s now become my go-to gift for all of the midwives in my life (and trust me, there are plenty of them), for birthdays or holidays or whenever you want to give someone something special.  The text reads: “In my dream he told me to hold the secret of his birth safe and teach him when he forgot”.  This artwork is perfect for the walls of your midwife’s office or clinic or home.

4. Books

I’m sure Spiritual Midwifery is already on your midwife’s bookshelf, so before purchasing books for your midwife, I first suggest that you puruse their bookshelf to ascertain what they do and do not already own.  Barring that, here are a few interesting and less obvious suggestions:

Pleasure reading:

The Birth House: A Novel

Baby Catcher: Chronicles of a Modern Midwife

A Midwife’s Story

A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812
Educational/ Informative:

Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood

Heart & Hands: A Midwife’s Guide to Pregnancy & Birth

Recreating Motherhood

The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (Johns Hopkins Studies in the History of Technology)

5. Jewelry

This might somewhat uphold the stereotype of the hippie midwife with the dangling goddess earrings, but if your midwife is that type of gal, then there’s some great stuff over on Attachments which fits that description.

And that’s pretty much all I can think of for now, although if anyone else has any other great suggestions, please let me know!

This is an interesting story about how difficult it was for a woman to obtain Plan B from Walgreen’s, over on the Consumerist.  Apparently the folks at her local Walgreen’s in Oxford, MS, tried to insist that she wait for one hour before getting the Plan B, as well as giving her literature on adoption, as well as just giving her a hard time and writing down her drivers’ license number.  I’m curious: has anyone else had difficulty in obtaining Plan B?  It seems like there’s a lot of confusion about it, especially in terms of the fact that it’s actually BIRTH CONTROL and not an abortion.